摘要
目的探讨完全腹腔镜下消化道重建技术在完整全结肠系膜切除(CME)的右半结肠切除术中的应用。方法整群收集2016年1月—2018年12月该院收治的61例施行完全腹腔镜下消化道重建的右半结肠切除术患者资料。结果61例患者,男性41例,女性20例,其中升结肠24例,回盲部18例,结肠肝曲处13例,横结肠近肝曲处6例,均在全腹腔镜下完成,无中转开腹。手术时间(163±21)min;术中出血量为(75±20)mL;术后淋巴结清扫数目平均为(24±13)枚;下切缘距回盲部均>15 cm,上切缘距肿瘤边缘均>10 cm,病理学显示所有手术标本残端无肿瘤的细胞残留,病理其分型:中分化腺癌45例,高分化腺癌15例,弥漫性大B细胞淋巴瘤1例。术后1例患者出现炎性肠梗阻,其他患者胃肠恢复为(3.5±1.8)d;术后均无出现出血、吻合口狭窄和吻合口漏等相关并发症,无伤口感染。术后住院天数为(11±2)d。术后随访3~6个月,无复发、肿瘤转移及切口处种植。结论完全腹腔镜下消化道重建技术在完整全结肠系膜切除(CME)的右半结肠切除术中安全可行。
Objective To investigate the application of complete laparoscopic digestive tract reconstruction in right hemicolectomy with complete total mesocolectomy(CME).Methods The data of 61 patients undergoing complete laparoscopic reconstruction of digestive tract in the hospital from January 2016 to December 2018 were group collected.Results 61 patients(M 41,F 20),including 24 cases of ascending colon,18 cases of ileocecum,13 cases of colon liver curvature and 6 cases of transverse colon near liver curvature,were completed under total laparoscopy without conversion to laparotomy.The operation time was(163±21)min,the amount of intraoperative bleeding was(75±20)mL,and the average number of lymph node dissection was(24±13).The distance between the lower incisor edge and the blind part of the gyrus was more than 15 cm,and the distance between the upper incisor edge and the edge of the tumor was more than 10 cm.Pathological examination showed that there were no tumor cell residues in the stump of all surgical specimens.Pathological classification:45 cases of moderately differentiated carcinoma,15 cases of well-differentiated carcinoma and 1 case of diffused large B-cell lymphoma.Inflammatory intestinal obstruction occurred in 1 patient after operation.The gastrointestinal recovery of other patients was(3.5±1.8)d.No bleeding,anastomotic leakage,anastomotic stenosis and wound infection occurred after operation.The postoperative hospital stay was(11±2)d.Follow-up for 3-6 months showed no recurrence,metastasis and incision implantation.Conclusion Complete laparoscopic reconstruction of digestive tract is safe and feasible in complete total mesocolectomy of right hemicolectomy.
作者
钟长毓
李建国
ZHONG Chang-yu;LI Jian-guo(Department of General Surgery,Zhengzhou Hospital,Zhangzhou,Fujian Province,363000 China)
出处
《中外医疗》
2019年第33期1-4,共4页
China & Foreign Medical Treatment
关键词
结肠肿瘤
完全腹腔镜
消化道重建
完整结肠系膜切除(CME)
Colon tumor
Complete laparoscopy
Digestive tract reconstruction technique
Complete total mesocolectomy(CME)
